Presentation at Inequality, Democracy and the New Human Biotechnologies: A Threshold Challenge for the 21st Century, New York, NY [PDF Version]

The new technologies of human genetic modification are among
the two or three most profoundly consequential technologies
of the 21st century. They have the potential for both great
good and great harm. They are being developed at an extraordinary
pace. There is little public oversight and control of their
development and use.

If these technologies are developed and used in the prevailing
context of free-market competition and individualist social
values, they could greatly exacerbate existing inequalities
in health and social power, and existing modes of discrimination
and exploitation. In addition, certain applications of these
technologies could open the door to a new high-tech eugenics
that would undermine the foundations of democratic civil society.

The dynamics of inequality, democracy and the new human biotechnologies
works the other way as well: at this moment, inequalities of
power and influence are themselves subverting democratic decision-making
concerning the development and use of the new human biotechnologies.
Surveys show that Americans are more uneasy about human biotechnologies
than they are about any other set of new technologies, yet they
feel unprepared to express clear opinions and feel intimidated
by experts. Meanwhile, few civil society constituencies have
identified the new human biotechnologies as issues of priority
concern. In the face of uncertainty among the public and the
absence of organizations that inform and mobilize public opinion,
the biotech industry and the bioscience research community are
moving to frame the public debate on their own terms and to
secure the commanding heights of the policy-making process.

I don't want to suggest that we should simplistically "oppose
biotechnology." That's like saying we should oppose penicillin
and yogurt. These technologies have benign and beneficent applications
as well as dangerous ones. But it's equally wrong to hold biotechnology
out as the Holy Grail, and to propose that voicing concern about
its social consequence is akin to the Pope seeking to silence
Galileo.

Rather, we need to summon our collective wisdom, maturity and
will to devise a nuanced set of responsible policies. Some human
biotechnologies will likely be judged to be unproblematically
beneficial, and should be affirmatively supported. Others pose
both benefits and risks - we won't want to ban them, but we'll
want to proceed very cautiously and make sure they are carefully
regulated. And some, hopefully few, may be judged to pose such
great risks, or be so clearly unacceptable, that they will need
to be proscribed.

The important point to realize is that at the present time,
in most countries and internationally, the institutions that
would allow such policies to be made and enforced simply do
not exist.

What technologies am I talking about, and what do risks they
pose?

Genetic testing and screening, both pre-natally and in combination
with IVF procedures, threatens new forms of discrimination and
stigmatization. Sex selection is dramatically reducing the ratio
of female to male infants born in developing countries, and
may change birth order patterns in the developed countries.
Patenting of human gene sequences represents a new enclosure
of a long-accepted commons. The push by the international biotechnology
community to promote genetic technologies as the solution to
health needs in developing countries threatens to redirect resources
from providing basic health care and addressing the social determinants
of health. Patenting of human embryos and the intentional conception
and birth of children for the primary purpose of supplying medically
useful tissues, sets us on a course towards the commodification
of human beings. Techniques to allow cloning for research are
being developed without safeguards to prevent their use to create
cloned children. "Gene-doping" is widely expected
to be developed and used by athletes within the next several
years, regardless of entreaties or sanctions. Biochemical, pharmacological
and surgical "enhancements" are rapidly becoming normalized
within elite social, cultural, and professional circles. Techniques
allowing the creation of genetically modified children could
spark a techno-eugenic rat race in which all would feel compelled
to compete lest they leave their children at a disadvantage.

If we are to ensure that the development of the new human biotechnologies
supports rather than subverts social justice, equality and democracy,
we need to affirm at least three principles and the institutions
they imply: first, that benign and beneficent technologies must
be available to all; second, that the precautionary principle
should be applied when assessing new human biotechnologies;
and third, that final decisions over the development and use
of new human biotechnologies should be make by democratically
accountable structures.

Skeptics may call these proposals utopian but that view is
refuted by an existence proof: Canada. Canada has a national
health program that ensures access to, among other things, pre-natal
and other genetic services approved for use. Landmark federal
legislation passed earlier this year by the Canadian Parliament
requires private firms and research institutions engaged in
any activities involving human eggs, sperm or embryos to obtain
a license ensuring that they operate in accordance with approved
policies. The law gives the green light to embryonic stem cell
research but imposes strict controls to ensure careful monitoring.
The law further establishes a new oversight agency, appointed
by the federal cabinet, to review and approve proposals for
controversial new genetic technologies. Finally, Canada bans
the patenting of human genetic sequences, embryos and gametes.
It's important to note that Canadian pro-choice and women's
health groups were closely involved in the drafting of the bill,
and that these same groups played a lead role in campaigning
for its passage.

Similar policies exist in most of Europe, in Australia and
elsewhere. Real-world models exist. There is no excuse - by
the United States or by any other country lacking responsible
policies - for complacency.

Still, the task we face will be anything but easy. Major social,
cultural and political challenges need to be overcome. We are
in a race for time and the stakes are enormous.

A major challenge is posed by the fact that opinions and intuitive
reactions concerning the new human biotechnologies don't fall
easily along the conventional left-right ideological spectrum.
Religious conservatives were the first to become vocal on high-profile
issues such as human cloning, and the popular press quickly
framed debate over the new human genetic technologies using
the conventional categories of abortion politics. This is seriously
misleading. Many pro-choice feminists and women's health advocates
oppose new genetic and reproductive technologies that put corporate
profits over women's health and well-being. Feminists additionally
raise concern about the commodification of reproduction and
human relationships. Disability rights leaders charge that a
society obsessed with genetic perfection could come to regard
the disabled as mistakes that should have been prevented. Civil
rights and human rights leaders are wary of a new free-market
eugenics that could stoke the fires of racial and ethnic hatred.
Many environmentalists see human genetic modification as another
potentially disruptive technology being approved before long-range
consequences are considered. In 2001 the People's Health Assembly,
representing hundreds of international health, development,
human rights, indigenous rights and other organizations, issued
a major declaration opposing the push by the global biotechnology
industry to place human genomics at the center of the global
health agenda.

It is true, however, and especially in the United States, that
the most well-organized constituencies active on human biotechnology
issues are, in fact, the biotechnology industry and the religious
conservatives, and in this sense the polarized framing adopted
by the press is accurate. The unfortunate consequence is that
if these remain the only choices available, liberals and progressives
will align with the biotech industry, and unwittingly find themselves
supporting policies antithetical to some of the deepest values
of social justice, equality and democracy, and to their own
historical traditions.

It is imperative that a third voice enter the debate, one representing
those not necessarily opposed to the new human genetic technologies
in principle, but who are very concerned about their social,
economic and political implications and who certainly don't
want to see the genetic future of the human species determined
by biotech industry obsessed with profits or celebrity scientists
obsessed with fame or notoriety.

Technologically, socio-culturally and politically, we are on
the verge of being pushed over a threshold, quite unawares,
into a new epoch of high-tech eugenics. Proponents argue that
the new eugenics will be the inevitable outcome of the free
play of human desire, individual choice, market economics, and
unfettered scientific research. They point to the rapidly growing
use and acceptance of prozac, viagra, cosmetic surgery and athletic
doping as harpingers of the far deeper transformation of human
biology that we can expect once genetic modification becomes
practical.

As they were in both the 19th and 20th centuries, eugenic technologies
and sensibilities are being promoted most vigorously by leading
figures in the scientific community. Nobel laureate James Watson
has called for the elimination of "stupid people"
and "ugly girls" through genetic modification and
selection. Media-savvy University of Pennsylvania bioethicist
Arthur Caplan argues that popular resistance to eugenics needs
to be overcome if we are to improve the human condition. Princeton
University bioethicist Peter Singer argues in favor of infanticide.
His colleague Lee Silver speaks glowingly of a future in which
humanity has engineered itself into genetic castes, the "GenRich"
and the "Naturals." University of Alabama bioethicist
Gregory Pence, asks, "Would it be so terrible to allow
parents to at least aim for a certain type, in the same way
that great breeders… try to match a breed to dog to the
needs of a family?" The list goes on.

We cannot allow this neoliberal eugenics to take root and flourish.
What happens to the social fabric when couples in the upper
5% of the income distribution begin availing themselves of these
technologies, and make no apologies about the fact that yes,
they intend to engineer their children to leave everyone else's
children in the dust? What happens when countries less disinclined
than the United States to authoritarianism announce a national
drive to eliminate genetic deficiencies and create a genetically
superior breed of human?

Humanity needs a crash course in the science and politics of
the new human biotechnologies. We need to repudiate eugenic
political ideologies and deepen our commitment to the human
community as such and to the dignity of all people. We need
to do this on a global scale and within less than a decade.
Individual counties, regional bodies and the United Nations
need to make these concerns priorities. National and international
leaders in politics, the sciences and the arts need to declare
that humanity is not going to let itself be split asunder by
the new human biotechnologies.

None of this will happen unless people organize to make it
happen. We need new programs within existing organizations,
and we need new organizations, to put these issues on the public
agenda in a compelling way. We need to foster new levels of
awareness, commitment and engagement - in short, a new social
movement - to ensure that the new human biotechnologies support
rather than endanger equality, democracy and social justice.
Such a movement will need to be of the same intensity, scope
and scale as the great movements of the past century that struggled
on behalf of working people, anti-colonialism, civil rights,
peace and justice, women's equality, and the environment. The
hour is late. There is no greater challenge.